Individual provider Active NPI

Constance Razzano, LMHC

  • Mental Health Counselor
  • Port St Lucie, FL
National Provider Identifier
1255719357
Registry record updated Jul 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH15481 Issued in FL
Practice address
269 NE Sagamore Ter
Port St Lucie, FL 34983-1262
Phone
(786) 520-6527
NPI assigned
May 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 27, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH15481 FL Primary

Addresses

Primary practice location

269 NE Sagamore Ter
Port St Lucie, FL 34983-1262

Mailing address

269 NE Sagamore Ter
Port St Lucie, FL 34983-1262
Phone (786) 520-6527

Other practice location 1

1100 South Federal Highway
Stuart, FL 34994
Phone (772) 320-0790

Other identifiers 1

IdentifierTypeStateIssuer
360339300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240516002751 FL Practitioner - Mental Health Counselor 3678914983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Helping People Succeed Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1255719357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 NE SAGAMORE TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831262",
            "telephone_number": "786-520-6527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "269 NE SAGAMORE TER",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349831262",
            "telephone_number": "786-520-6527"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 South Federal Highway",
            "address_purpose": "LOCATION",
            "city": "Stuart",
            "state": "FL",
            "postal_code": "34994",
            "country_code": "US",
            "telephone_number": "772-320-0790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAZZANO",
        "first_name": "CONSTANCE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-11",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH15481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "360339300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.